Overview

Walking on the toes or the balls of the feet, also known as toe walking, is fairly common in children who are just beginning to walk. Most children outgrow it.

Kids who continue toe walking beyond the toddler years often do so out of habit. As long as your child is growing and developing normally, toe walking is unlikely to be a cause for concern.

Toe walking sometimes can result from certain conditions, including cerebral palsy, muscular dystrophy and autism spectrum disorder.

Source: http://www.mayoclinic.com

Symptoms

Toe walking is walking on the toes or the ball of the foot.

When to see a doctor

If your child is still toe walking after age 2, talk to your doctor about it. Make an appointment sooner if your child also has tight leg muscles, stiffness in the Achilles tendon or a lack of muscle coordination.

Source: http://www.mayoclinic.com

Causes

Typically, toe walking is a habit that develops when a child learns to walk. In a few cases, toe walking is caused by an underlying condition, such as:

• A short Achilles tendon. This tendon links the lower leg muscles to the back of the heel bone. If it's too short, it can prevent the heel from touching the ground.
• Cerebral palsy. Toe walking can be caused by a disorder of movement, muscle tone or posture caused by injury or abnormal development in the parts of the immature brain that control muscle function.
• Muscular dystrophy. Toe walking sometimes occurs in this genetic disease in which muscle fibers are unusually prone to damage and weaken over time. This diagnosis might be more likely if your child initially walked normally before starting to toe walk.
• Autism. Toe walking has been linked to autism spectrum disorders, which affect a child's ability to communicate and interact with others.

Source: http://www.mayoclinic.com

Diagnosis

Toe walking can be observed during a physical exam. In some cases, the doctor may do a gait analysis or an exam known as electromyography (EMG).

During an EMG, a thin needle with an electrode is inserted into a muscle in the leg. The electrode measures the electrical activity in the affected nerve or muscle.

If the doctor suspects a condition such as cerebral palsy or autism, he or she may recommend a neurological exam or testing for developmental delays.

Source: http://www.mayoclinic.com

Complications

Persistent toe walking can increase a child's risk of falling. It can also result in a social stigma.

Risk factors

Toe walking out of habit, also known as idiopathic toe walking, sometimes runs in families.

Source: http://www.mayoclinic.com